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D Dicker

Publications and source records attributed to D Dicker.

At least 73 records · Page 4Linked to original sources
PubMed1989

The vaginal contraceptive diaphragm and the condom--a reevaluation and comparison of two barrier methods with the rhythm method.

The use-effectiveness and continuation rates of two barrier methods of contraception, the diaphragm and condom, were studied during a two-year follow-up in a group of 85 and 98 women, respectively. All were highly motivated. Results were compared to a group of 64 women using the periodic abstinence or rhythm method, i.e. not using any contraceptive. The patients selected the method of contraception they preferred and were instructed in their proper use. Results showed good continuation rates in the groups using a diaphragm and the condom for 2 years, for a total follow-up of 5570 cycles. Pregnancy rate after 24 months of use, as calculated by Pearl's formula, was 2.48 for the diaphragm, 3.21 for the condom, and 5.19 in the rhythm group. No serious side effects or complications occurred in either group. The study demonstrated a fair acceptability and use-effectiveness for barrier contraceptive. We suggest that these harmless and complication-free methods may still be reasonable alternatives for the "modern" methods, the pill and the IUD.

Adolescent↗
PubMed1989

IVF-ET in women with refractory polycystic ovarian disease.

Polycystic ovarian disease may be a cause of hormonal infertility. This condition is often refractory to therapy. Three groups of randomly chosen women with refractory polycystic ovarian disease (PCOD) were treated by induction of ovulation with pFSH/hCG, pFSH/hMG/hCG or after down-regulation of the ovaries with a GnRH analogue (Decapeptyl). Out of 18 patients six conceived in the first in vitro fertilization-embryo transfer (IVF-ET) cycle, and two further women conceived in a later cycle. It is suggested that patients with refractory PCOD should be referred for IVF-ET therapy, possibly after treatment with a GnRH analogue.

Adult↗
PubMed1989

Ovarian cyst formation: a complication of gonadotropin-releasing hormone agonist therapy.

Since gonadotropin-releasing hormone (GnRH) analogs were introduced into clinical therapeutic use, several side effects directly related to the hypoestrogenic state have been reported. The authors have encountered a rather infrequent complication, namely ovarian cystic formations, when using these compounds for selected in vitro fertilization and embryo transfer (IVF-ET) cases. In 7 of 24 patients with Decapeptyl (D-Trp6-luteinizing hormone-releasing hormone [LH-RH], Ferring, Kiel, FRG) treatment, and in 5 of 22 patients treated with Buserelin (Superfact, Hoechst A.G., Frankfurt, FRG), solitary ovarian cysts developed during the down-regulation phase. Their growth did not change during ovulation induction with menotropins. Although the mechanism of ovarian cyst formation during GnRH agonist treatment is not clear, their presence does not appear to interfere with the fertility of these women.

Buserelin↗
PubMed1989

The impact of spermatic vein ligation on the male factor in in vitro fertilization-embryo transfer and its relation to testosterone levels before and after operation.

Criteria for improved semen quality after varicocele operations are not clear, as they do not express sperm fertilization capacity, its most important qualification. Twenty-two couples, 12 with mechanical female infertility (group I) and 10 with normal female fertility (group II), in whom the husband had subfertile semen in the presence of varicocele, and who had failed preoperative in vitro fertilization-embryo transfer (IVF-ET) attempts, were readmitted for the IVF-ET procedure following the repair of varicocele. In group I, a 20% pregnancy rate was achieved after the operation, while no pregnancies occurred before surgery. In group II, four pregnancies (40%) were achieved after operation. Plasma testosterone (T) levels demonstrated a significant increase in 50% of the patients in both groups after surgery, resulting in a concurrent improved fertilization, cleavage, and pregnancy rates.

Embryo Transfer↗
PubMed1989

The value of GnRH analogue therapy in IVF in women with unexplained infertility.

Seventy-six women with unexplained infertility, undergoing in-vitro fertilization and embryo transfer (IVF-embryo transfer), were selected for three different ovulation induction protocols. In group I, induction of ovulation was performed with pure follicle-stimulating hormone/human menopausal gonadotrophin/human chorionic gonadotrophin (pFSH/HMG/HCG). Group II patients were given a combined therapy consisting of a gonadotrophin-releasing hormone (GnRH) analogue, decapeptyl (DTRP6) followed by pFSH/HMG/HCG. In group III, patients underwent two IVF-embryo transfer cycles, serving as their own controls. The initial cycle was induced with pFSH/HMG/HCG while the second was stimulated using decapeptyl/pFSH/HMG/HCG. Significantly higher rates of fertilization, cleavage and pregnancy (P less than 0.001, P less than 0.07, P less than 0.001, respectively) were achieved in group II patients to whom combined GnRH agonists and gonadotrophins were given. Furthermore, among group III patients, no pregnancies occurred during the initial IVF-embryo transfer cycles whereas a 23% pregnancy rate (P less than 0.001) was obtained after GnRH agonist therapy. Our results indicate that the combination of GnRH agonists and gonadotrophins is of value in cases of unexplained infertility. Further, larger studies must be performed before the true efficacy of this mode of therapy can be determined in women with unexplained infertility.

Adult↗
PubMed1989

Is elective cerclage justified in the management of triplet and quadruplet pregnancy?

The main complication in multiple gestation with more than two fetuses is prematurity, with its concomitant increase in perinatal mortality and morbidity. Clearcut indications as to management of these pregnancies are lacking, and the efficiency of elective cerclage is controversial. Twelve triplets and three quadruplets out of 27 multiple pregnancies were electively sutured and compared to 10 triplets and two quadruplets without this procedure. Otherwise, both groups were managed uniformly regarding bed-rest, beta-mimetic drugs and dexamethasone for the enhancement of fetal lung maturity. Mean duration of pregnancy in patients with cerclage was 35 weeks, significantly longer than those who did not undergo this procedure (30.7 weeks) (p < 0.01). Furthermore, in the former group, the mean neonatal weight was significantly higher (p < 0.01), mean Apgar scores were better, significantly lower rates of respiratory distress syndrome occurred (p < 0.05), perinatal mortality rate was significantly reduced (p < 0.01) and the mean hospitalization period was shorter (p < 0.025). It seems that elective cervical suture is a definite contribution to the successful management of multiple pregnancies with more than two fetuses.

Apgar Score↗
PubMed1989

Effect of cell cycle stages on the central density of Enterococcus faecium ATCC 9790.

Cultures of Enterococcus faecium growing at various rates were examined for timing of cell division cycle events by using the method of residual divisions and a morphological analysis. Both methods gave essentially the same timing for the onset of D1 (completion of chromosome replication) and of D2 (completion of septation). Frequencies of cells exhibiting a phase-reversed center in bovine serum albumin at various growth rates were determined. The data fit a model in which rapidly growing cells increase in refractive index (which is assumed to represent central density) at completion of the chromosome replication cycle involved in the ongoing division, whereas slowly growing cultures increase in central density at the time of completion of septation. There was no correlation between the timing of increase in central density and the timing of initiation of new sites of surface growth.

Cell Cycle↗
PubMed1989

The vanishing fetus. A report of 17 cases of triplets and quadruplets.

The incidence of multiple conceptions is higher than the incidence of multiple deliveries. The "vanishing fetus" is a relatively new concept being a direct result of the advent of ultrasonography. Early first trimester loss of one or more conceptuses accounts for this phenomenon. The patient may be symptomatic (bleeding, pain, abdominal cramps) but in most instances, the finding is fortuitous. We report 17 cases of a vanishing fetus in a multiple gestation of greater than twins. In 13 patients one fetus vanished in the course of pregnancy while in four cases two fetuses disappeared from each gestation. The phenomenon was observed up to the 16th week of pregnancy. It is our feeling that the finding of a vanishing fetus should be recorded early, as the prognosis for pregnancy bleeding is different than in the singleton pregnancy. Thus information regarding this phenomenon should be given to couples who consider artificial reduction of fetuses in the multiple gestation.

Female↗
PubMed1988

Ovarian cyst aspiration during in vitro fertilization/embryo transfer (IVF/ET) cycles.

Fifteen patients treated in an IVF program with ovarian cysts were retrospectively evaluated. Ten women with ovarian cysts formed during induction of ovulation were treated by puncture and aspiration and compared to a control group of five patients in whom the ovarian cysts could not be punctured. Induction protocols in both groups were based on hMG/hCG or pFSH/hCG administration. In patients in the study group the mean volume aspirated from cysts was 7.4 +/- 2.1 ml. Mean estrogene (E2) levels on the day of hCG were 1411 +/- 213 and 1036 +/- 177 pg/ml in the hMG and pFSH groups, respectively. Mean progesterone (p) levels were 1.6 +/- 0.4 and 1.9 +/- 0.3 ng/ml, respectively. Oocyte collection was done with the aid of a vaginal ultrasound transducer. A mean of 6.2 and 5 oocytes was picked up respectively, with a fertilization rate of 74.3 and 69.1%. In all cases embryo transfer was performed. Two clinical pregnancies were achieved, one in each of the induction protocol groups. In the control group, patients underwent early luteinization, i.e., requiring cancelation of the cycle, after the ovarian cysts had not been aspirated. It is suggested that puncture and aspiration of ovarian cysts occurring during induction of ovulation may be an efficient method to avoid early luteinization. It should be evaluated further.

Adult↗
PubMed1988

Spontaneous abortion in patients with insulin-dependent diabetes mellitus: the effect of preconceptional diabetic control.

Fifty-nine of 94 pregnant women with juvenile-onset insulin-dependent diabetes who attended a preconceptional clinic were periodically examined by a diabetologic team. Glycemic control was obtained by intensified insulin therapy and monitored by blood glucose self-monitoring. These women were compared with the 35 pregnant women who did not receive preconceptual glycemic control. The initial glucose and maternal hemoglobin A1 values of the latter group experiencing spontaneous abortions were significantly higher (p less than 0.001) when compared with women receiving preconceptional diabetologic counseling whose pregnancies continued beyond 22 weeks' gestation. The frequency of spontaneous abortions among patients not seen before pregnancy was significantly higher (p less than 0.001), in contrast to attending women, whose rate represented the normal rate in the general population. We confirm the evidence accumulated in the recent literature that poor metabolic control around conception and in the early weeks of pregnancy may be the determining factor favoring abortion.

Abortion, Spontaneous↗
PubMed1988

Primary abdominal pregnancy: can artificial abortion, endometriosis and IUD be etiological factors?

Primary abdominal pregnancy is a very rare condition, accompanied by high rates of perinatal and maternal mortality. The etiology of this condition is not clear; nevertheless several theories have been proposed. We have reported three cases in whom the etiological factors may have been the presence of an IUD, and patches of endometriosis adjacent to the site of the pregnancy in two cases. It is suggested that in cases suspected of ectopic pregnancy, in the presence of IUD or other pelvic pathology, it should first be determined whether it is the dangerous condition of abdominal pregnancy, in view of the high mortality rates.

Abortion, Induced↗
PubMed1988

Mullerian adenosarcoma of the uterus: report of a rare case and review of the literature.

A rare case of Mullerian adenosarcoma of the uterus is described, found during diagnostic curettage. Panhysterectomy was performed. These rare tumors have a low potential for malignancy and are characterized by benign epithelial and malignant stromal elements. They should be distinguished from the highly malignant mixed Mullerian tumors which contain, by definition, both carcinomatous and sarcomatous elements. The literature on the subject has been reviewed.

Female↗
PubMed1988

Fetal surveillance in insulin-dependent diabetic pregnancy: predictive value of the biophysical profile.

Ninety-eight insulin-dependent diabetic pregnancies underwent monitoring by means of 978 biophysical profiles from 28 weeks' gestation until parturition. Only 2.9% of the 978 tests had abnormal results (score less than or equal to 7). When performed within 2 days before birth, a normal biophysical profile predicted the 1-minute Apgar score to be normal in 92% and 5-minute Apgar score in 99%. When all biophysical profiles ever performed were included, the predictive value improved to 100%. The baby's first cry within 1 minute after birth was predicted in 95%. Furthermore, the predictive value of a normal biophysical profile regarding the absence of ominous intrapartum cardiotocographic patterns was excellent (95%). The specificity was in general good (80% to 90%), but the predictive value of abnormal test results and sensitivity were almost without exception poor. It seems that the very low rate of abnormal biophysical profiles indicates that obstetric interventions were made immediately after the occurrence of the first sign of fetal jeopardy; thus improved results were obtained.

Amniotic Fluid↗